Provider Demographics
NPI:1053974212
Name:MARTINEZ, ISRAEL (NP)
Entity type:Individual
Prefix:
First Name:ISRAEL
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 LOUETTA RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2139
Mailing Address - Country:US
Mailing Address - Phone:281-257-7793
Mailing Address - Fax:
Practice Address - Street 1:12550 LOUETTA RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2139
Practice Address - Country:US
Practice Address - Phone:281-257-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP141361OtherTEXAS BOARD OF NURSING
TX652915OtherTEXAS BOARD OF NURSING